15 results on '"Avani R Patel"'
Search Results
2. Adoption of Opioid-Sparing and Non-Opioid Regimens After Breast Surgery in a Large, Integrated Health Care Delivery System
- Author
-
Alison Savitz, Veronica Shim, Patience Odele, Elizabeth Linehan, Margaret Mentakis, Brooke Vuong, Avani R Patel, Sharon B. Chang, Gillian Kuehner, and Garner Low
- Subjects
medicine.medical_specialty ,Breast surgery ,medicine.medical_treatment ,Psychological intervention ,Breast Neoplasms ,030230 surgery ,03 medical and health sciences ,0302 clinical medicine ,Surgical oncology ,Internal medicine ,medicine ,Humans ,Pain Management ,Practice Patterns, Physicians' ,Medical prescription ,Pain, Postoperative ,business.industry ,Emergency department ,Analgesics, Opioid ,Regimen ,Oncology ,Opioid ,030220 oncology & carcinogenesis ,Morphine ,Surgery ,business ,medicine.drug - Abstract
Postoperative prescriptions have contributed to the opioid epidemic. In response, a large, integrated health care delivery system implemented initiatives to reduce outpatient opioid prescriptions. We evaluated the impact of these interventions on opioid-prescribing practices after breast surgery. We examined postoperative prescribing practices before and after the 2016–2018 intervention period. Primary endpoints were the use of non-opioid regimens (NORs) and morphine milligram equivalents (MMEs) prescribed for postoperative pain management, while secondary endpoints were emergency department (ED) visits and readmissions within 7 days of surgery. In a survey of breast surgeons, 23% reported using NORs in 2017 versus 79% in 2019 (p
- Published
- 2020
- Full Text
- View/download PDF
3. Abstract P1-20-23: Eliminating postoperative opioids for outpatient breast surgery in a large integrated healthcare system
- Author
-
Sharon B. Chang, Avani R Patel, and Gillian Kuehner
- Subjects
Cancer Research ,medicine.medical_specialty ,Oncology ,business.industry ,Breast surgery ,medicine.medical_treatment ,medicine ,Intensive care medicine ,business ,Healthcare system - Abstract
Introduction: The epidemic of opioid addiction and overdose has become a public health emergency in the United States. Opioids prescribed for postoperative pain management have contributed significantly to this epidemic. At the Permanente Medical Group (TPMG), reducing postoperative opioid prescriptions has become a priority. A pilot study in 2016 led by TPMG breast surgeons showed that pain after lumpectomy can be managed effectively without opioids. The results of this study were disseminated to all TPMG breast surgeons via a February 2017 webinar. In November 2018, TPMG implemented an outpatient Enhanced Recovery After Surgery (ERAS) initiative that included reducing postoperative opioid prescriptions. The objective of our study was to evaluate self-reported changes in TPMG breast surgeon opioid-prescribing practices after these interventions. Methods: An online survey was created to assess perioperative and postoperative practices. This survey was distributed to TPMG breast surgeons before the 2017 educational webinar about non-opioid regimens, and again in June 2019, more than 6 months after the implementation of the outpatient ERAS initiative. Questions included how surgeons manage patient expectations during the initial consultation, surgeons’ preoperative pain medication regimens, intraoperative pain management including nerve blocks, local anesthetics, ketorolac use, and postoperative pain management. We used a chi-square test to compare differences between the two surveys. Results: We received 13 responses from a group of over 100 TPMG breast surgeons in 2017 and 29 responses from 59 surgeons in 2019. Overall, self-reported non-opioid regimens increased between 2017 and 2019, with only 23% of surgeons using these regimens for lumpectomy in 2017 and 79% in 2019 (p TPMG Self-Reported Opioid Prescribing Patterns After Lumpectomy, 2017 vs 2019# Opioid Tablets Prescribed After Lumpectomy% of Surgeons Prescribingp-value201720190237930150NAUnspecified153NA Notably, non-opioid regimens were also reported by 66% of surgeons for lumpectomy with sentinel lymph node biopsy (SLNbx), 41% for mastectomy without reconstruction, and 14% for mastectomy with implant-based reconstruction. 2019 Self-Reported Opioid Prescribing Patterns After Different Types of Breast Operations% of Surgeons Prescribing# Opioid Tablets Prescribed, by Type of OperationLumpectomyLumpectomy With Sentinel Lymph Node BiopsyMastectomy Without ReconstructionMastectomy With Reconstruction0796641141 to 1071021311 to 20717282821-3033710>310007Unspecified3333Per plastics00034 Conclusion: Self-reported postoperative opioid prescribing practices for breast surgery have changed significantly after implementation of TPMG initiatives, with the majority of TPMG breast surgeons prescribing no opioids after lumpectomy with or without SLNbx, and many prescribing no opioids after mastectomy. In future work, we aim to validate the self-reported data using pharmacy prescription data from 2017-2019. We also plan to identify perioperative factors that are predictive of successful non-opioid postoperative pain management such as the use of nerve blocks, non-steroidal anti-inflammatory drugs (NSAIDs), gabapentin, and acetaminophen. Citation Format: Avani R Patel, Gillian E Kuehner, Sharon B. Chang. Eliminating postoperative opioids for outpatient breast surgery in a large integrated healthcare system [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-20-23.
- Published
- 2020
- Full Text
- View/download PDF
4. ASO Visual Abstract: Adoption of Opioid-Sparing and Non-opioid Regimens After Breast Surgery in a Large Integrated Health Care Delivery System
- Author
-
Patience Odele, Brooke Vuong, Avani R Patel, Elizabeth Linehan, Veronica Shim, Sharon B. Chang, Garner Low, Margaret Mentakis, Alison Savitz, and Gillian Kuehner
- Subjects
medicine.medical_specialty ,business.industry ,Breast surgery ,medicine.medical_treatment ,Health care delivery ,Oncology ,Opioid ,Surgical oncology ,medicine ,Opioid sparing ,Surgery ,Intensive care medicine ,business ,medicine.drug - Published
- 2020
- Full Text
- View/download PDF
5. The Patient Selection Criteria for Veno-arterial Extracorporeal Mechanical Oxygenation
- Author
-
Sandeep Banga, Shantanu Singh, Vamsi Emani, Avani R Patel, and Abhiram Challa
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Cardiology ,extracorporeal membrane oxygenation (ecmo) ,cardiac arrest ,030204 cardiovascular system & hematology ,Controlled studies ,Pulmonary Dysfunction ,Extracorporeal ,03 medical and health sciences ,0302 clinical medicine ,Internal Medicine ,medicine ,Extracorporeal membrane oxygenation ,Intensive care medicine ,Selection (genetic algorithm) ,venoarterial extracorporeal membrane oxygenation (va-ecmo) ,business.industry ,Cardiogenic shock ,Mortality rate ,cardiogenic shock ,General Engineering ,Oxygenation ,medicine.disease ,surgical procedures, operative ,business ,030217 neurology & neurosurgery - Abstract
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) plays a crucial role in the management of patients with refractory cardiac and pulmonary dysfunction by providing temporary mechanical hemodynamic and respiratory support. However, the paucity of guidelines on indications for administering it and the failure to timely initiate VA-ECMO often result in a high in-hospital mortality rate and poor six-month outcomes after VA-ECMO deployment. Due to ethical issues, randomized controlled studies with VA-ECMO have not been conducted so that no recommended evidence-based guidelines exist for VA-ECMO patient-selection criteria. Therefore, the indication for administering the device depends solely on expert opinion after reviewing the literature. We conducted a review of the current literature to better understand and classify the need for proper patient selection, including proven indications for VA-ECMO.
- Published
- 2019
- Full Text
- View/download PDF
6. Case of Irreducible Ileocecal Intussusception Due to Leiomyoma of the Colon
- Author
-
Avani R Patel, Harvey Rainville, and Amar R Patel
- Subjects
Pathology ,medicine.medical_specialty ,Stromal cell ,irreducible ileocecal intussusception ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Ileocecal valve ,0302 clinical medicine ,ileocecal valve ,Intussusception (medical disorder) ,leiomyoma ,medicine ,Young adult ,intussusception ,ileoileal intussusception ,business.industry ,Ileocecal intussusception ,General Engineering ,Gastroenterology ,medicine.disease ,intestinal obstruction ,Small intestine ,Leiomyoma ,Lymphatic system ,medicine.anatomical_structure ,General Surgery ,business ,030217 neurology & neurosurgery - Abstract
Intussusception is defined as the telescoping of the proximal segment of the bowel into the distal segment. In most clinical cases, pediatric intussusception is much more common than adult intussusception. Pediatric intussusception is often due to viral or bacterial infections, which lead to the inflammation of lymphoid tissue in the intestine. Adult intussusception is typically secondary to tumors and idiopathic causes. Malignant tumors tend to affect the colon, while benign tumors affect the small intestine. Lipomas are the leading cause of benign tumors which cause intussusception. Conversely, adenocarcinomas are the leading cause of malignant tumors that cause intussusception. Our case focuses on a young adult who developed intussusception secondary to a leiomyoma present near the ileocecal junction of the intestine. The treatment of intussusception caused by tumors is either surgical reduction or excision of the involved tissue. If excised, the specimens are sent to the pathology department for confirmation of the potential cause. If leiomyomas are suspected, staining is used to differentiate them from gastrointestinal stromal tumors (GISTs). These stromal tumors are unusual causes of intussusception, which require further research to determine their disease course and age at presentation.
- Published
- 2019
7. Global Initiative for Chronic Obstructive Lung Disease: The Changes Made
- Author
-
Avani R Patel, Amar R Patel, Shivank Singh, Shantanu Singh, and Imran Khawaja
- Subjects
Spirometry ,forced expiratory volume in one second ,medicine.medical_specialty ,Vital capacity ,Pulmonology ,Best practice ,spirometry ,030204 cardiovascular system & hematology ,abcd assessment tool ,smoking ,chronic obstructive pulmonary disease (copd) ,03 medical and health sciences ,0302 clinical medicine ,long-acting beta-2 agonist ,forced vital capacity ,Internal Medicine ,Medicine ,Intensive care medicine ,persistent airflow limitation ,COPD ,medicine.diagnostic_test ,business.industry ,global initiative for chronic obstructive lung disease ,General Engineering ,Global strategy ,Effective management ,medicine.disease ,Obstructive lung disease ,Review article ,respiratory tract diseases ,copd exacerbation ,business ,030217 neurology & neurosurgery - Abstract
Chronic obstructive pulmonary disease or COPD is one of the conditions that physicians frequently see in both the hospital and outpatient setting. In order to improve diagnostic and treatment outcomes, the Global Strategy for the Diagnosis, Management and Prevention of COPD, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) was created in 2001. Every year, a new report is generated based on an analysis of published studies which attempts to improve the way physicians handle COPD. GOLD reports are considered to be essential evidence-based reference tools for the implementation of effective management plans, and represent the current best practices for the care of patients with COPD. The 2017 report greatly revised the guidelines and added a few components that changed the system of COPD diagnosis and treatment. This review article addresses those changes, explains the current guidelines, and draws attention to areas that still require improvement.
- Published
- 2019
8. Management of Resistant Hypertension Based on Recommendations from Different Guidelines and the Systolic Blood Pressure Intervention Trial
- Author
-
Tinoy Kizhakekuttu, Shantanu Singh, Avani R Patel, Sudhir Mungee, and Sandeep Banga
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Cardiology ,Resistant hypertension ,Catheter ablation ,resistant hypertension management ,030204 cardiovascular system & hematology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal Medicine ,medicine ,In patient ,Intervention trial ,Intensive care medicine ,Confusion ,sprint study ,business.industry ,General Engineering ,resistant hypertension ,Regimen ,Blood pressure ,chemistry ,Spironolactone ,jnc 8 ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
The long-term management of patients with resistant hypertension has been made even more difficult by a "moving target" goal blood pressure (BP). The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guidelines defined resistant hypertension as the failure to achieve goal BP in patients who are adhering to full doses of an appropriate three-drug regimen that includes a diuretic. The Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 8) guidelines laid out more lenient target BP goals, without addressing the definition of resistant hypertension directly. The present scenario is a state of confusion, with providers selectively adopting recommendations from different guidelines. The Systolic Blood Pressure Intervention Trial (SPRINT) trial contributed to the confusion with further evidence supporting the strict control of hypertension. In addition, the failure of another trial on renal denervation in the US has essentially put an end to six long years of experimentation with catheter ablation in patients with resistant hypertension. Other therapies are still experimental. Adding a new dimension of medical management, spironolactone has made a comeback in resistant hypertension, with reports of better responsiveness when added to existing anti-hypertensive therapy. The present review discusses the current state and management options for patients with resistant hypertension considering the new evidence. Newer advances in pharmacological and device therapy are also discussed to improve understanding and quality in the management of resistant hypertension.
- Published
- 2019
- Full Text
- View/download PDF
9. Venovenous Extracorporeal Membrane Oxygenation Therapy in Adults
- Author
-
Shantanu Singh, Shivank Singh, Amar R Patel, Nancy J Munn, and Avani R Patel
- Subjects
semi-seldinger technique ,Pulmonology ,medicine.medical_treatment ,extracorporeal membrane oxygenation (ecmo) ,030204 cardiovascular system & hematology ,barotrauma ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Internal Medicine ,Cardiopulmonary bypass ,Extracorporeal membrane oxygenation ,venovenous extracorporeal membrane oxygenation (vv-ecmo) ,seldinger technique ,Medicine ,Oxygenator ,membrane lung ,Lung ,business.industry ,apss ,General Engineering ,Cannula ,murray score ,acute respiratory distress syndrome (ards) ,medicine.anatomical_structure ,age-adjusted oxygenation index ,Respiratory failure ,Anesthesia ,Breathing ,business ,Airway ,030217 neurology & neurosurgery - Abstract
Extracorporeal membrane oxygenation (ECMO) therapy is used as supportive therapy for patients with respiratory failure, cardiac failure, and cardiopulmonary failure. Venovenous extracorporeal membrane oxygenation (VV-ECMO) is one subtype used for respiratory failure as a supportive treatment for critically ill patients. The principle behind it is that the membrane lung (oxygenator) is placed sequentially with the normal lungs rather than in parallel like with cardiopulmonary bypass, therefore, the lungs do not have to work as hard to oxygenate the blood. Then using a drainage cannula, blood is drained from the right atrium (RA) and after going through the membrane lung, the newly oxygenated blood is returned back to the RA. Because of this, there is enough systemic oxygen delivery to manage metabolism and preserve the airway even at lower tidal volume ventilation settings. With ventilator settings placed at lower tidal volume, there is less risk of barotrauma. This is a review article discussing VV-ECMO therapy with adult patients. It will also go into detail regarding its indications, contraindications, configurations, patient assessment, vascular access, and complications.
- Published
- 2019
- Full Text
- View/download PDF
10. Applied Uses of Extracorporeal Membrane Oxygenation Therapy
- Author
-
Imran Khawaja, Avani R Patel, Shivank Singh, Amar R Patel, and Shantanu Singh
- Subjects
medicine.medical_specialty ,pulmonary embolism ,Pulmonology ,medicine.medical_treatment ,extracorporeal membrane oxygenation (ecmo) ,030204 cardiovascular system & hematology ,Extracorporeal ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Extracorporeal membrane oxygenation ,Internal Medicine ,venovenous extracorporeal membrane oxygenation (vv-ecmo) ,Intensive care medicine ,Mechanical ventilation ,venoarterial extracorporeal membrane oxygenation (va-ecmo) ,business.industry ,cardiopulmonary resuscitation (cpr) ,Cardiogenic shock ,cardiogenic shock ,General Engineering ,respiratory failure ,medicine.disease ,lung rest ,sepsis-induced cardiomyopathy ,Review article ,Pulmonary embolism ,femoral vein ,surgical procedures, operative ,Respiratory failure ,Supportive psychotherapy ,Cardiac/Thoracic/Vascular Surgery ,business ,030217 neurology & neurosurgery - Abstract
Extracorporeal membrane oxygenation (ECMO) therapy has been around since the 1970s and has completely changed how critical care physicians view supportive therapy for certain patients. ECMO therapy is a supportive therapy provided by a mechanical extracorporeal circuit that is able to directly oxygenate and remove carbon dioxide from the blood. By performing this, ECMO can provide cardiac, respiratory, or combined cardiopulmonary supportive therapy in cases of failure. ECMO therapy also places less emphasis on invasive mechanical ventilation, which prevents barotrauma and gives rest to the lungs. Therefore, they are used for several different conditions. This review article focuses on the definition, principles, types, and practical applications of ECMO therapy.
- Published
- 2019
11. The Underlying Stroke Etiology: A Comparison of Two Classifications in a Rural Setup
- Author
-
Avani R Patel, Amar R Patel, and Soaham Desai
- Subjects
TOAST Classification ,medicine.medical_specialty ,small vessel disease ,hypertension ,Disease ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,atherothrombosis ,Epidemiology ,Health care ,medicine ,Internal Medicine ,ischemic stroke ,cardiac pathology ,other causes ,Intensive care medicine ,Stroke ,Cause of death ,business.industry ,General Engineering ,medicine.disease ,Dissection ,Neurology ,dissection ,ascod classification ,Etiology ,rural healthcare ,business ,030217 neurology & neurosurgery ,toast classification - Abstract
Introduction This study compares the Trial of Org 10172 in Acute Stroke Treatment (TOAST) and the atherothrombosis, small vessel disease, cardiac pathology, other causes, and dissection (ASCOD) classification performed in a rural hospital setup. Stroke is the second leading cause of death after ischemic heart disease with over 9.5 million new cases of ischemic stroke in 2016. Stroke is a complex disease with numerous contributing factors. India needs a standardized stroke classification system, as without one it becomes difficult to collect data on stroke patients, perform follow-ups, and provide appropriate secondary prevention. A standardized stroke classification system would also help in building a nationwide database in order to note epidemiological trends of ischemic stroke. This would also create greater awareness regarding stroke in rural parts of India where healthcare is difficult to access. Aims and objectives Our aim was to review all admitted stroke patients’ data and classify their etiology and mechanism based on the TOAST and ASCOD classification systems. The ASCOD classification has yet to be utilized in the Indian population. The two classifications are then compared in order to gain a better insight into which classification is a better fit for the Indian population. Both are based on the etiology of ischemic stroke but the ASCOD classification differs because it gives suitable secondary prevention measures based on the diseases linked to stroke. ASCOD also gives a proper indication of the patient’s present causative factor (similar to TOAST) and other factors that can possibly lead to further recurrences. This is different from TOAST, which denotes only a single cause for stroke and eliminates the possibility of other involved contributing factors. Materials and methods All patients involved in the study were admitted to a rural Indian hospital from January 2014 to July 2016. All the relevant clinical details of each patient were then retrieved from the hospital’s electronic medical record system for the study. We then classified all the patients based on the TOAST and ASCOD classification criteria. Results Using the ASCOD classification, we found that 179 (86%) patients out of 209 had either atherothrombosis or small vessel disease. The ASCOD classification also showed substantial evidence that the determined stroke mechanism/etiology is interconnected to multiple causal factors in over 50% of patients. In contrast, the TOAST classification had identified a larger number of ischemic stroke patients as having an etiology of other and undetermined causes as compared to the ASCOD classification. Conclusion The ASCOD classification is better to use in patients and helps decide the secondary prevention appropriately.
- Published
- 2019
12. Acute Hemiballismus as the Presenting Feature of Parietal Lobe Infarction
- Author
-
Avani R Patel, Soaham Desai, and Amar R Patel
- Subjects
tetrabenazine ,medicine.medical_specialty ,Infarction ,030204 cardiovascular system & hematology ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Basal ganglia ,Internal Medicine ,hemichorea-hemiballismus syndrome ,medicine ,hemiballismus ,Stroke ,Hemiballismus ,subthalamic nucleus ,business.industry ,parietal lobe ,General Engineering ,Parietal lobe ,Chorea ,medicine.disease ,stroke ,Subthalamic nucleus ,Neurology ,basal ganglia ,Cardiology ,hemichorea ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
It is widely believed that hemiballismus and chorea are suggestive of a basal ganglia subthalamic nucleus lesion; however, this not a rule. We report the case of a 63-year-old male with complaints of slurred speech, increased movement of the left half of his body, and headache. He had diabetes, hypertension, and a past medical history of stroke with residual weakness over the right side of his body. The patient developed the sudden onset of irregular, large amplitude, increased involuntary movements of his left upper and lower limbs with a flinging pattern. His blood sugar and serum osmolality were normal. His magnetic resonance imaging (MRI) showed an acute right parietal lobe infarction. Patients can experience hemiballismus with lesions other than the subthalamic nucleus in the basal ganglia. This is contrary to the classic belief that hemiballismus is associated with, and only with, lesions in the subthalamic nucleus. This manuscript describes a case of hemiballismus occurring in a patient secondary to a parietal lobe infarction.
- Published
- 2019
- Full Text
- View/download PDF
13. Cardiac Ultrasound in the Intensive Care Unit: A Review
- Author
-
Imran Khawaja, Avani R Patel, Shivank Singh, Amar R Patel, and Shantanu Singh
- Subjects
medicine.medical_specialty ,Cardiology ,030204 cardiovascular system & hematology ,Cardiac Ultrasound ,law.invention ,Cardiac dysfunction ,transthoracic echocardiography ,03 medical and health sciences ,0302 clinical medicine ,rapid ultrasound for shock and hypotension ,law ,Intensive care ,hemodynamic echocardiography ,focused assessment with transthoracic echocardiography ,Internal Medicine ,limited transthoracic echocardiogram ,medicine ,focused rapid echocardiographic evaluation ,Ejection fraction ,ultrasound ,business.industry ,Ultrasound ,General Engineering ,Stroke volume ,Intensive care unit ,Review article ,bedside echocardiographic assessment in trauma/critical care ,transducer ,Emergency medicine ,focused ultrasound ,business ,030217 neurology & neurosurgery - Abstract
Transthoracic echocardiography (TTE) is an incredibly valuable tool in today's emergency rooms and intensive care units (ICUs). It has the ability to provide a complete evaluation of the structure and function of the heart, the valves, stroke volume, ejection fraction, and much more. Previous academic studies have also determined that point-of-care TTE done by non-cardiologist physicians can also provide higher accuracy in patient assessment and management, with potential prognostic impact by assessing the severity of cardiac dysfunction and response to treatment. The aim of this review article is to examine further these point-of-care evaluations, what they entail, their benefits, and where further research would better our own understanding.
- Published
- 2019
- Full Text
- View/download PDF
14. Central Line Catheters and Associated Complications: A Review
- Author
-
Shantanu Singh, Amar R Patel, Shivank Singh, Avani R Patel, and Imran Khawaja
- Subjects
medicine.medical_specialty ,Resuscitation ,complications ,pneumothorax ,medicine.medical_treatment ,complication ,030204 cardiovascular system & hematology ,central venous catheterization ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Internal Medicine ,catheter knot ,Vein ,Central line ,business.industry ,General Engineering ,medicine.disease ,bleeding ,infection ,Surgery ,Review article ,medicine.anatomical_structure ,Parenteral nutrition ,Pneumothorax ,General Surgery ,Hemodialysis ,business ,Complication ,subclavian vein cannula insertion ,030217 neurology & neurosurgery - Abstract
The use of a central line or central venous catheterization was brought to attention in 1929 when Dr. Werner Forssmann self-inserted a ureteric catheter through his cubital vein and into the right side of his heart. Since that time the central line technique has developed further and has become essential for the treatment of decompensating patients. Central lines are widely used for anything from rapid fluid resuscitation, to drug administration, to parenteral nutrition, and even for administering hemodialysis. Central lines come in different sizes, types, and sites of administration. Sometimes their use can be associated with complications as well. The following review article addresses these parameters of central lines and goes into detail regarding their complications.
- Published
- 2019
15. The Association Between Obstructive Sleep Apnea and Arrhythmias
- Author
-
Imran Khawaja, Avani R Patel, Shivank Singh, Shantanu Singh, and Amar R Patel
- Subjects
medicine.medical_specialty ,Pulmonology ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Epidemiology ,Medicine ,atrial fibrillation ,obstructive sleep apnea ,Cause of death ,Fibrillation ,business.industry ,Apneic episodes ,Mortality rate ,General Engineering ,Atrial fibrillation ,medicine.disease ,continuous positive airway pressure therapy ,respiratory tract diseases ,Obstructive sleep apnea ,Cardiology ,medicine.symptom ,business ,Airway ,arrhythmias ,030217 neurology & neurosurgery - Abstract
Obstructive sleep apnea (OSA) is caused by intermittent episodes of partial or complete closure of the upper airway, leading to apneic episodes while the patient is asleep. Atrial fibrillation (AF) leads to more than 750,000 hospitalizations per year and accounts for an estimated 130,000 deaths each year. The death rate from AF as the primary or a contributing cause of death has been rising for more than two decades. The material reviewed in this paper focuses on the association between OSA and arrhythmias. It goes into the details of the epidemiology, pathophysiology, and types of arrhythmias and the therapies seen in association with OSA.
- Published
- 2019
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.